| NPI | 1730763012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11011992) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A187715) |
| 363LF0000X Nurse Practitioner, Family (Licence: NH 116921-23) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1217744) | |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024196687) | |
| 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP004503) | |
| 363LF0000X Nurse Practitioner, Family (Licence: ID 6871999) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 18119-33) | |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2026-03-27 |